原发性扁桃体滤泡性淋巴瘤的临床病理特征  

Clinicopathological charateristics of primary follicular lymphoma in tonsil

作　　者：孙大菊[1] 杨华[1] 王连有[1] 刘学娟[1] 钟艳平[1] 

机构地区：[1]吉林大学中日联谊医院病理科,吉林长春130033

出　　处：《吉林大学学报（医学版）》2011年第3期505-508,F0003,共5页Journal of Jilin University：Medicine Edition

基　　金：卫生部科教司科研基金资助课题(1994-2-158);吉林省长春市科技局科研基金资助课题(2001-086-510)

摘　　要：目的:按照WHO 2008年淋巴造血组织肿瘤的最新分类,对原发性扁桃体滤泡性淋巴瘤(FL)的临床特征、形态学和免疫表型进行观察分析,探讨其与淋巴结原发性FL的异同,以利于诊断和鉴别诊断。方法:复习37例原发于扁桃体FL患者的临床资料及诊断切片,免疫组织化学染色后观察LCA、CD20、CD79a、CD45RO、CD3、CD10、Bcl-6和Bcl-2的表达情况。结果:37例原发性扁桃体FL患者中,活检前临床诊断扁桃体肿物28例,扁桃体癌6例,淋巴瘤3例。组织形态与淋巴结内FL类似,滤泡型4例,滤泡和弥漫型1例,少滤泡型32例,无弥漫型。低级别(1-2级)17例,高级别(3级)20例。免疫组织化学染色均表达LCA及B细胞标记物CD20和CD79a,不表达CK及T细胞的标记物CD45RO和CD3。CD10阳性率43.24%,Bcl-6阳性率86.48%,CD10和Bcl-6共表达率为37.83%;22例表达Bcl-2,阳性率59.46%;CD10、Bcl-6、Bcl-2在低级别FL和高级别FL中的表达率比较差异均无统计学意义(P>0.05)。2例发生在儿童的扁桃体FL其形态及免疫表型均与WHO新分类的儿童FL相同。结论:扁桃体FL组织形态与淋巴结FL相似,本组活检标本中以少滤泡型为主,高级别占多数。B细胞和生发中心标记物的表达情况与淋巴结FL基本一致,而Bcl-2表达低。Objective According to the latest WHO Classification of tumours of haematopoietic and lymphoid tissues in 2008,to observe and analyze the clinical features,morphology and immunophenotypes of primary follicular lymphoma（FL）in the tonsil,and explore its similarities and differences with FL in the lymph node,and contribute to the diagnosis and identified dignosis.Methods The clinical data and diagnostic biopsys of 37 patients with primary FL in the tonsil were reviewed,the expressions of LCA,CD20,CD79a,CD45RO,CD3,CD10,Bcl-6 and Bcl-2 were observed using immunohistochemical staining.Results The clinical diagnosis before biopsy was 28 cases of tumor,6 cases of tonsillar cancer and 3 cases of lymphoma patients in 37 patients with primary FL in tonsil.The morphological characteristics were similar to nodal FL,there were 4 cases of follicles,1 case of follicles and diffuse,32 cases of less follicles,no diffuse type.17 cases of grade 1-2,20 cases of grade 3.The LCA and B cell markers,CD20 and CD79a were positive expressed;the CK and T cell markers,CD45RO and CD3 were negative expressed by immunohistochemical staining.The expression rates of CD10 and Bcl-6 were 43.24% and 86.48%,the co-expression rate of CD10 and Bcl-6 was 37.83%;22 cases expressed the Bcl-2,the positive rate was 59.46%;the expression rates of CD10,Bcl-6,Bcl-2 in low-grade FL and high-grade FL had no statistically significant differences（P0.05）.The morphology and immunophenotype of 2 cases occurred in children tFL were similar to the new WHO classification with subtypes of the children FL.Conclusion The morphological feature of tonsil FL is similar to lymph node FL,in the biopsy specimens the less follicular and the high-grade are the most.The expressions of germinal center markers and B cell markers are basically the same as lymph node FL,while the expression rate of Bcl-2 is lower than that of lymph node FL.

关 键 词：滤泡性淋巴瘤 扁桃体肿瘤/病理学 

分 类 号：R733[医药卫生—肿瘤]